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I'm having a hip replacement and I'm not ashamed to admit I'm pretty darned scared. I watched my father go through this 25 years ago and it wasn't pretty. Please tell me things have changed since then and my operation will go smoothly.

You didn't say what went wrong with your father's surgery and/or hip implant so we can't comment on how things might be different for him if he had the same surgery today. We can tell you that over the last 25 years, many improvements have been made in hip replacement surgery. Combined together, these changes have made this procedure much more successful resulting in a stable hip and a fairly easy recovery for the patient. Of course, any surgery has the risk of potential problems and complications. Your surgeon will go over these with you during your pre-operative visit. Tell your surgeon about your fears, worries, and concerns. Being calm as you enter surgery is always better than being stressed-out and exhausted from your worries. Ask him or her to show you the type of implant that will likely be used. A mini-lesson on the advantages and benefits of the chosen replacement might also allay your worries. Basically, there are six separate groups or classifications of hip implants. All six types have equally good rates of survival and success. By name, these include: 1) single wedge, 2) double wedge, 3) tapered, 4) cylindrical, 5) modular, and 6) anatomic. The tapered implant has three separate types: round, cone, or rectangle (referring to the top of the stem that fits into the round ball that replaces the head of the femur). Each of the unique design features of these six types has important characteristics and purposes. The surgeon chooses the implant design that is best for each patient on a case-by-case basis. The different shapes allow for different areas of bone-to-implant fixation needed for a stable unit. The shape of the stem (whether tapered, round, curved, or straight) also influences bone-to-implant fixation by changing the contact points between these two surfaces. For example, tapered stems are wider at the top and narrower at the bottom. Bone fixation is greater at the top where there is more surface to latch onto. The bottom-line is like you, all patients want a hip replacement that is sturdy, strong, and holds up for many years. Both surgeon and patient want to avoid implant loosening, sinking down into the bone, or breaking. The overall goal of all implants (no matter what their design) is to make contact with the bone and stabilize the joint.

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